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Progressive congestive heart failure due to common iliac arteriovenous fistula: a case report

Naoyuki Sata1, Kiyohisa Hiramine, Takashi Horinouchi

  • 1Division of Cardiology, Shinkyo Hospital, Usuki 3-41 - 1, Kagoshima, Kagoshima 890-0073. sanao@m.kufm.kagoshima-u.ac.jp

Journal of Cardiology
|April 21, 2007
PubMed

Insights

Acute heart failure in a 64-year-old man was successfully treated after surgical repair of a rare common iliac arteriovenous fistula. This intervention resolved symptoms caused by the significant arteriovenous shunt.

Area of Science:

  • Cardiology
  • Vascular Surgery

Background:

  • Arteriovenous shunts can cause heart failure.
  • Heart failure secondary to common iliac arteriovenous fistula is uncommon.

Observation:

  • A 64-year-old male presented with acute heart failure, dyspnea, and left leg swelling.
  • He had bilateral common iliac aneurysms, one with venous perforation causing a large arteriovenous fistula.
  • Cardiac catheterization revealed a high shunt rate (80.6%) and significant hemodynamic changes.

Findings:

  • Despite medical management with diuretics, the patient's heart failure, pleural effusion, and ascites worsened.
  • Surgical intervention involving aneurysm replacement and direct fistula closure was performed.
  • Postoperative recovery was complete, with resolution of all symptoms.

Implications:

  • This case highlights the importance of considering rare arteriovenous fistulas in the etiology of refractory heart failure.
  • Surgical correction of common iliac arteriovenous fistulas can be a life-saving treatment.
  • Prompt diagnosis and surgical management are crucial for favorable outcomes in such complex cases.

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